This is a prospective study that looks into the prevalence of chorda tympani nerve (CTN) injury and related symptoms following varying degrees of trauma to the nerve during three common types of middle-ear operation: myringoplasty, tympanotomy and mastoidectomy. The number of patients with CTN-related symptoms varied widely between the three groups. Increased occurrence of the nerve related symptoms and a prolonged recovery time were observed in the tympanotomy group. Stretching of the nerve produced more symptomatic cases than cutting it in the myringoplasty and mastoidectomy groups. Recovery was complete in 92 percent of the symptomatic patients by 12 months. It is important to inform patients about the possibility of CTN injury during middle-ear operations, and it should also be emphasized that symptoms related to CTN injury can occur irrespective of the type of damage to the nerve.

The purpose of our study was to determine the success rate of myringoplasty in adults and children and to examine whether the hearing improvement is a potential indication for surgery. We performed a 6-year prospective audit study in a cohort of patients undergoing myringoplasty at the University Teaching Hospital, Department of Otolaryngology and Head and Neck Surgery. Two hundred and eleven patients who underwent myringoplasties were included in the study. All were performed by a postaural approach using autologous temporalis fascia and underlay technique. The total success rate, in terms of graft uptake at 3-6 months, was 91.5% and an overall hearing improvement was achieved in 91.5% of cases. This was statistically significant (P < 0.001). Only weak correlation was found between hearing improvement and age (Pearson's r = 0.175, P = 0.024), and there was no significant difference in hearing improvement across gender (P = 0.164), size (P = 0.198) or site (P = 0.447) of the perforation. Myringoplasty is an operation that can improve hearing in many cases independently of age, gender and the size and site of the perforation. Patients who undergo myringoplasty should be advised whilst been consented that there is a good chance of hearing improvement.

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The aetiology of post-tonsillectomy fever is obscure. Bacteraemia during surgery, anaesthetic agents and the inflammatory response of tissue to injury have been implicated. A prospective study was undertaken in 100 consecutive children to evaluate the occurrence and severity of fever in the 24 h after tonsillectomy and its relationship to bacteraemia during surgery and qualitative and quantitative cultures (colony counts) of organisms in tonsil core tissue. Fifty-four patients had a fever (> 37.5 degrees C) postoperatively, of whom, 30 had a fever greater than 38 degrees C. Blood cultures during tonsillectomy were positive in 22 patients. There was no statistically significant difference between the occurrence of fever and the techniques of tonsillectomy and haemostasis. There was also no association between positive blood, core or surface cultures and the incidence or severity of fever nor any association between colony count in core cultures and fever. Our results suggest that postoperative fever in the 24 h following tonsillectomy is not caused by infection.

A retrospective and prospective study has been carried out to assess the morbidity associated with the techniques of diathermy and ligation in controlling tonsillectomy haemorrhage. No difference was found in the incidence of haemorrhage between the two techniques. The use of diathermy cuts the operation time by 26%, and has no increase in morbidity.